In my nine months of pregnancy, I had more medical appointments than I remember having in my previous 35 years of life. When I told my GP I was pregnant, I received a stack of blood test and ultrasound referral forms, and once I selected an obstetrician this stack of forms became a weekly occurrence.
Despite the fact I never returned an abnormal result on any of the dozens of tests I had between conceiving and giving birth to my son, the tests just seemed to beget more tests, like some kind of medical Tough Mudder course full of elaborate obstacles I had to jump over – or waddle over with increasing difficulty – to earn the ultimate prize of having a baby.
I was weighed and scanned at every doctor’s appointment and towards the end I was told to record the number of times my son kicked every hour. I was told what position to sleep in, given a meal plan of healthy foods to stick to and urged to wear a smart watch lest my heart rate go above a “dangerous” level during exercise. Flagged as a risk for post-partum depression, having dealt with episodes of anxiety before, I was given an induction with a counsellor at my birthing hospital, on top of the regular hospital induction with a midwife and the recommended eight-hour course on what to expect from the birth. I have had some relatively serious health issues in the past, but none came close to the level of intense medical monitoring that seems to be de rigueur for pregnant people.
I’ll pause my whinge here and say that it’s undoubtedly a privilege to live in a country with a health system as good as Australia’s and to receive the care of some really wonderful professionals through my pregnancy and delivery. But I was shocked that when the real physical and mental shift came – when I actually had the baby – all those doctors, nurses, radiologists, midwives and counsellors disappeared, and the pamphlets about what to expect or do next stopped abruptly. Aside from one appointment with my obstetrician six weeks after birth, which consisted of checking my lower organs were working relatively normally and suggesting I get in contact next time I got pregnant, I was not given any follow-up care.
At that point, I had just had major surgery and had debilitating pain that required medication most days and would leave me unable to resume my normal exercise regime for months. My breasts were leaking non stop and I was too weak to hold myself up for long periods. I had no close family nearby who knew anything about babies to provide practical support for me or my husband, who was equally exhausted. I was in a constant state of hyper-vigilance and brain fog that left me unable to rest or function for most of the day and at the mercy of severe and frightening mood swings I’d never had before.
While I felt like I could have done without the majority of medical appointments through my pregnancy, now was when I really needed that professional guidance. Instead, like most birthing parents, I fell victim to the model of care we offer during the most difficult transition of their lives, which seems to assume the journey ends at childbirth.
In my sleep-deprived, vulnerable state I tried to find my own resources to explain what I was going through. When I was finally able to access bulk-billed counselling by joining a long waitlist of struggling mothers, my therapist pointed me to a study noting that childbirth causes changes in women’s brains, as less important aspects for the task of baby care – such as responding to social cues, and memory storage – are deleted to make way for expanded functions like risk assessment and emotional regulation.
Taken alongside the physical effects of birthing a baby – including recovery that often lasts long past the perfunctory six-week medical signoff and permanent changes to the mother’s body – this season of change is commonly known as “matrescence” and its combined effects on the body and brain are more dramatic than puberty.
This is not a period of life when we should be leaving new parents to fend for themselves. On a recent episode of parenting podcast Beyond the Bump, Dr Oscar Serrallach, who specialises in post-partum care, explained he takes expectant parents through planning sessions to educate them on the post-partum process and put as many supports in place as possible, from psychologists to help with household tasks.
Of course, paying for a $200-an-hour therapist or personal doula is simply not possible for many of us. But by reviewing the way medical care is structured for mothers, can we not incorporate some of these elements into the health system?
Surely there are parts of the extremely rigorous pregnancy care model we could make optional, in exchange for subsidisation of post-birth support for parents who may be missing the “village” of family around them. Our children depend on us to be healthy and capable of caring for them when they enter the world just as much as before.
• Sarah Kendell is a marketing and communications consultant and freelance writer
